EGFR、HER-2/neu蛋白在胃癌中的表达及其预后价值研究

目的 研究胃癌组织中表皮生长因子受体(EGFR)、HER-2/neu蛋白的表达与临床病理特征及生存时间的关系,探讨其作为胃癌预后指标的可行性.方法 应用免疫组织化学法检测103例胃癌标本中EGFR、HER-2/neu蛋白的表达,并将检测结果与患者临床病理特征进行综合分析.结果 在103例胃癌组织中,EGFR、HER-2/neu蛋白的阳性表达率分别为42.7%(44/103)、31.1%(32/103),而胃正常组织中均无表达.EGFR、HER-2/neu蛋白表达与患者的性别、年龄、肿瘤大小、部位、分化程度均无相关性(P＞0.05),而与肿瘤的浸润深度、病理分期、淋巴结转移、远处转移相关(P＜0.05).EGFR、HER-2/neu蛋白表达阳性患者的中位生存时间分别为11.0和10.1个月,表达阴性患者的中位生存时间分别为65.2和64.5个月,表达阳性与阴性患者的生存时间有显著性差异(P＜0.05).EGFR与HER-2/neu蛋白联合表达与生存时间相关(PEGFR＝0.027,PHER-2/neu＝0.000,rEGFR＝1.965,rHER-2/neu＝3.153),二者阳性表达时有减少胃癌患者生存时间的危险,HER-2/neu阳性表达的危险度相对较大.结论 测定胃癌组织中EGFR、HER-2/neu蛋白的表达,有助于判断患者预后,也为分子靶向治疗药物在胃癌的应用提供了理论依据.

Studies on the expressions of EGFR and HER-2/neu in gastric cancer and their prognostic value

Objective To investigate the expressions of epidermal growth factor receptor(EGFR)and HER-2/neu protein in gastric cancer,and their relationship with pathologic features and survival time,and to discuss the feasibility of EGFR and HER-2/neu as prog- nostic markers.Methods 103 samples of gastric cancer were studied by immunohistochemical technique to detect the expressions of EGFR and HER-2/neu in those specimens,and the findings were then comprehensively analyzed in collaboration with pathological changes and their follow-up data.Results The positive expression of EGFR was detected in 44 of 103 gastric cancer specimens(42.7%),the positive expression of HER-2/neu was found in 32 of 103 gastric cancer specimens(31.1%),while neither the EGFR nor the HER-2/neu was ex- pressed in normal gastric tissue.No correlation existed between their expressions in neoplastic tissues with sex,age,size and site of tumor and the degree of differentiation(P>0.05).The expressive rates of both EGFR and HER-2/neu were related to the depth of invasion,the clinical stage,lymph node metastasis,distant metastasis and the survival time of patients(P<0.05).The raedian survival time of patients with positive expression of EGFR and HER-2/neu was 11.0 and 10.1 months,respectively,while the median survival time of patients with negative expression of EGFR and HER-2/neu was 65.2 and 64.5 months,respectivdy.There existed significant difference on the survival time between the patients with or without EGFR expression(P<0.05).The combined expression of both EGFR and HER-2/neu was correlated to the survival time of patients(P_(EGFR)=0.027,P_(HER-2/neu)=0.000,r_EGFR=1.965,r_(HER-2/neu)=3.153).Positive expressions might herald a short survival time,and the positive expression of HER-2/neu might be even more predictive.Conclusion Determination of the expression of EGFR and HER-2/neu in gastric cancer tissues may be helpful to determine the prognosis,guide the treatment for the patients,and help establish a theoretical basis for the clinical application of molecular targeted drugs,such as IMC-C225 and Herceptin.